scholarly journals The Effect of Switching to Second-Line Antiretroviral Therapy on the Risk of Opportunistic Infections Among Patients Infected With Human Immunodeficiency Virus in Northern Tanzania

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Habib O. Ramadhani ◽  
John A. Bartlett ◽  
Nathan M. Thielman ◽  
Brian W. Pence ◽  
Stephen M. Kimani ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Failure Criteria ◽  
Failure Diagnosis ◽  
World Health ◽  
Second Line ◽  
Immunological Failure ◽  
Second Line Antiretroviral Therapy

Abstract Background.  Due to the unintended potential misclassifications of the World Health Organization (WHO) immunological failure criteria in predicting virological failure, limited availability of treatment options, poor laboratory infrastructure, and healthcare providers’ confidence in making switches, physicians delay switching patients to second-line antiretroviral therapy (ART). Evaluating whether timely switching and delayed switching are associated with the risk of opportunistic infections (OI) among patients with unrecognized treatment failure is critical to improve patient outcomes. Methods.  A retrospective review of 637 adolescents and adults meeting WHO immunological failure criteria was conducted. Timely and delayed switching to second-line ART were defined when switching happened at <3 and ≥3 months, respectively, after failure diagnosis was made. Cox proportional hazard marginal structural models were used to assess the effect of switching to second-line ART on the risk of developing OI. Results.  Of 637 patients meeting WHO immunological failure criteria, 396 (62.2%) switched to second-line ART. Of those switched, 230 (58.1%) were delayed. Switching to second-line ART reduced the risk of OI (adjusted hazards ratio [AHR], 0.4; 95% CI, .2–.6). Compared with patients who received timely switch after failure diagnosis was made, those who delayed switching were more likely to develop OI (AHR, 2.2; 95% CI, 1.1–4.3). Conclusion.  Delayed switching to second-line ART after failure diagnosis may increase the risk of OI. Serial immunological assessment for switching patients to second-line ART is critical to improve their outcomes.

Time to Switching to Second-line Antiretroviral Therapy and Its Predictors Among HIV/AIDS Infected Children at General Hospitals, Northern Ethiopia: A Survival Analysis

2021 ◽  
Author(s):  
Migbar Sibhat ◽  
Tewodros Mulugeta ◽  
Dawit Aklilu
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Rank Test ◽  
P Value ◽  
Northern Ethiopia ◽  
Second Line ◽  
Cox Proportional Hazard Regression ◽  
Adherence Monitoring ◽  
Second Line Antiretroviral Therapy

Abstract BackgroundWith expanding access to pediatric antiretroviral therapy, a growing amount of patients in the developing world has switched to second-line therapy, and some requiring third-line medications. A delay in switch increases mortality and risk of developing opportunistic infections. There remain limited and often conflicting estimates on the use of second-line ART in children. Thus, this study intended to determine the incidence and predictors of switching to second-line antiretroviral therapy among children.MethodsRetrospective follow up study was conducted by reviewing all charts. Data were collected by extraction tool; entered using Epi-data; cleaned and analyzed by STATA V-14. Kaplan-Meier curve, log-rank test, and life table were used for data description and adjusted hazard ratios and p-value for analysis by Cox proportional hazard regression. Any variable at P≤0.25 in the bi-variable analysis was taken to multivariate analysis and significance was declared at P≤0.05. Data were presented using texts, tables, and figures.Results and conclusionAnalysis was conducted on 424 charts with total person-time observation of 11686.1 child-months and incidence switch rate of 5.6 (95% CI 4.36-7.09) per 1000 child-month-observations. Being orphaned [AHR=2.36; 95%CI: 1.10-5.07], suboptimal ART adherence [AHR= 2.10; 95% CI: 1.12-3.92], drug toxicity [AHR= 7.05; 95% CI: 3.61-13.75], advanced recent WHO stage [AHR=2.75; 95%CI: 1.05-7.15], and initiating ART with TB co-infection [AHR=3.08; 95%CI: 1.26-7.51] were significantly associated with switch to second-line ART regimen. Moreover, long duration of ART follow up [AHR=0.75; 95% CI: 0.71-0.81] was found to be protective against switching. Hence, it is better to give priority for strengthening the focused evaluation of tuberculosis co-infection and treatment failure with continuous adherence monitoring. Further research is also needed to evaluate the effect of drug resistance.

scholarly journals Relationship between untimed plasma lopinavir concentrations and virological outcome on second-line antiretroviral therapy

AIDS ◽  
2018 ◽  
Vol 32 (3) ◽  
pp. 357-361 ◽  
Author(s):  
Gwamaka E. Mwasakifwa ◽  
Cecilia Moore ◽  
Dianne Carey ◽  
Janaki Amin ◽  
Paul Penteado ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Second Line ◽  
Virological Outcome ◽  
Second Line Antiretroviral Therapy

Outcomes After Second-Line Antiretroviral Therapy in Children Living with HIV in Latin America

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kayla Somerville ◽  
Cathy A. Jenkins ◽  
James G. Carlucci ◽  
Anna K. Person ◽  
Daisy Maria Machado ◽  
...  
Keyword(s):  
Latin America ◽  
Antiretroviral Therapy ◽  
Second Line ◽  
Living With Hiv ◽  
Second Line Antiretroviral Therapy

15 THE EFFECT OF PROTEASE INHIBITOR AS A SECOND-LINE ANTIRETROVIRAL THERAPY WITH HYPERTENSION AND RENAL FUNCTION AMONG HIV PATIENTS IN SANGLAH GENERAL HOSPITAL, BALI

2018 ◽  
Vol 36 ◽  
pp. e4-e5
Author(s):  
Muhammad Faisal Putro Utomo ◽  
Petrus Kanisius Yogi Hariyanto ◽  
Anindia Reina Yolanda ◽  
Nur Rizky Amaliah ◽  
Ni Made Dewi Dian Sukmawati ◽  
...  
Keyword(s):  
Renal Function ◽  
Antiretroviral Therapy ◽  
Protease Inhibitor ◽  
General Hospital ◽  
Second Line ◽  
Hiv Patients ◽  
Second Line Antiretroviral Therapy
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